Definition and Diagnosis
Acute Stress Disorder involves the same symptom clusters as PTSD — intrusion, avoidance, negative mood, arousal, and dissociation — but is diagnosed when symptoms occur between three days and one month after a traumatic event.
Epidemiology
Prevalence varies widely depending on the type of trauma, ranging from roughly 6% to over 30% following events such as assault, accidents, or disasters. Not everyone who develops Acute Stress Disorder goes on to develop PTSD.
Risk Factors
Risk factors mirror those for PTSD, including trauma severity, prior psychiatric history, and lack of post-trauma support. Peritraumatic dissociation is a particularly strong predictor of Acute Stress Disorder.
Symptoms and Subtypes
Symptoms include intrusive distressing memories, dissociative symptoms such as a sense of unreality, avoidance of reminders, negative mood, and hyperarousal, all emerging in the immediate weeks after the traumatic event. At least nine symptoms across these categories are typically required for diagnosis.
Diagnosis
DSM-5-TR criteria specify onset within one month of trauma exposure and duration of three days to one month; symptoms persisting beyond a month prompt reassessment for PTSD. Clinical interview and trauma history are central to diagnosis.
Treatment
Trauma-focused CBT is the primary evidence-based treatment, often delivered in brief, structured formats given the short diagnostic window. Psychoeducation, safety planning, and support for practical stressors following the trauma are also important.
Prognosis
Many individuals recover within weeks with appropriate support, though a significant proportion go on to develop PTSD if symptoms persist beyond a month. Early treatment can reduce the likelihood of progression to a chronic trauma disorder.
Reference
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).